NURS 807 Pathophysiology and Pharmacology |
Physical Examination Test Questions with Corrrect
Answers
Questions 1–200 | Comprehensive Pathophysiology,
Pharmacology & Physical Examination Review |
100% Pass Guaranteed | Graded A+
1. A 68-year-old male presents with sudden-onset tearing chest pain radiating to the back.
His blood pressure is 180/100 mmHg in the right arm and 140/80 mmHg in the left arm.
Which of the following is the most appropriate initial diagnostic test?
A. Electrocardiogram (ECG)
B. Chest X-ray
C. CT angiography of the chest
D. Transthoracic echocardiogram
ANS: C
Explanation: The clinical presentation of tearing chest pain with a blood pressure differential
between arms is highly suggestive of aortic dissection. CT angiography is the gold standard
diagnostic test with high sensitivity and specificity. ECG may show non-specific changes but is
not diagnostic. Chest X-ray may show a widened mediastinum but is not definitive. Transthoracic
echocardiogram can visualize the aortic root but is operator-dependent and less reliable for the
entire thoracic aorta.
2. A 72-year-old female with a history of heart failure presents with acute shortness of
breath and orthopnea. Her oxygen saturation is 88% on room air. Which of the following
is the most appropriate initial intervention?
A. Administer furosemide 40 mg IV
B. Apply supplemental oxygen and position upright
C. Obtain a stat chest X-ray
D. Administer morphine sulfate
,ANS: B
Explanation: The immediate priority is to address hypoxemia with supplemental oxygen and
position the patient upright to improve respiratory mechanics. Furosemide (A) is an appropriate
treatment for fluid overload but follows initial stabilization. Chest X-ray (C) is diagnostic but does
not address the immediate oxygenation deficit. Morphine (D) is used selectively and is not first-
line.
3. A 58-year-old male with a history of cirrhosis presents with hematemesis. Vital signs are
BP 88/50 mmHg, HR 118 bpm. After stabilizing the airway and initiating fluid
resuscitation, what is the priority pharmacological intervention?
A. Administer vitamin K intravenously to correct coagulopathy
B. Initiate an octreotide infusion to decrease splanchnic blood flow
C. Administer lactulose to prevent hepatic encephalopathy
D. Start empiric broad-spectrum antibiotics
ANS: B
Explanation: In patients with suspected variceal hemorrhage, octreotide is the standard of care
to reduce portal venous pressure by constricting splanchnic vessels. Vitamin K (A) is slow-acting
and does not stop acute bleeding, lactulose (C) is for ammonia management, and while
antibiotics (D) are indicated later, octreotide is the priority for controlling the active hemorrhage.
4. A 55-year-old patient with cirrhosis presents with ascites. Which of the following is the
first-line pharmacological treatment for ascites management?
A. Furosemide
B. Spironolactone
C. Hydrochlorothiazide
D. Mannitol
ANS: B
Explanation: Spironolactone is first-line for ascites in cirrhosis due to hyperaldosteronism.
Furosemide may be added but is not first-line. Hydrochlorothiazide and mannitol are not used.
5. A patient with cirrhosis has hepatic encephalopathy. Which medication is first-line?
,A. Lactulose
B. Rifaximin
C. Metronidazole
D. Neomycin
ANS: A
Explanation: Lactulose is first-line for hepatic encephalopathy, reducing ammonia absorption by
acidifying the colon. Rifaximin is often added. Metronidazole and neomycin are alternatives.
6. A 58-year-old female presents with a 3-month history of progressive shortness of breath
and a dry cough. On examination, she has clubbing and fine basal crackles. Which of the
following is the most likely diagnosis?
A. Idiopathic pulmonary fibrosis (IPF)
B. COPD
C. Bronchiectasis
D. Pulmonary oedema
ANS: A
Explanation: The combination of progressive dyspnoea, dry cough, clubbing, and fine basal
crackles is classic for IPF.
7. A 68-year-old male presents with a 2-week history of progressive shortness of breath
and orthopnoea. On examination, he has elevated JVP, bilateral basal crackles, and
pitting oedema. Which of the following is the most likely diagnosis?
A. Heart failure
B. COPD exacerbation
C. Pulmonary embolism
D. Pneumonia
ANS: A
Explanation: The combination of dyspnoea, orthopnoea, elevated JVP, crackles, and oedema is
classic for heart failure.
, 8. A 45-year-old male presents with a 1-week history of severe, colicky abdominal pain and
vomiting. He has a history of previous abdominal surgery. On examination, there are
high-pitched bowel sounds. Which of the following is the most likely diagnosis?
A. Small bowel obstruction
B. Large bowel obstruction
C. Acute pancreatitis
D. Gastroenteritis
ANS: A
Explanation: The combination of colicky abdominal pain, vomiting, and high-pitched bowel
sounds in a patient with a history of abdominal surgery is classic for small bowel obstruction due
to adhesions.
9. A 55-year-old male presents with acute-onset, severe epigastric pain radiating to the
back. He has a history of alcohol use. Which of the following is the most likely diagnosis?
A. Acute pancreatitis
B. Perforated peptic ulcer
C. Myocardial infarction
D. Biliary colic
ANS: A
Explanation: The acute onset of severe epigastric pain radiating to the back in a patient with a
history of alcohol use is classic for acute pancreatitis.
10. A 70-year-old female presents with a 6-month history of progressive difficulty with
balance and coordination. On examination, she has an ataxic gait and intention tremor.
Which of the following is the most likely diagnosis?
A. Cerebellar degeneration
B. Parkinson's disease
C. Peripheral neuropathy
D. Vestibular dysfunction
ANS: A
Explanation: The combination of an ataxic gait and intention tremor is characteristic of
cerebellar dysfunction.
Physical Examination Test Questions with Corrrect
Answers
Questions 1–200 | Comprehensive Pathophysiology,
Pharmacology & Physical Examination Review |
100% Pass Guaranteed | Graded A+
1. A 68-year-old male presents with sudden-onset tearing chest pain radiating to the back.
His blood pressure is 180/100 mmHg in the right arm and 140/80 mmHg in the left arm.
Which of the following is the most appropriate initial diagnostic test?
A. Electrocardiogram (ECG)
B. Chest X-ray
C. CT angiography of the chest
D. Transthoracic echocardiogram
ANS: C
Explanation: The clinical presentation of tearing chest pain with a blood pressure differential
between arms is highly suggestive of aortic dissection. CT angiography is the gold standard
diagnostic test with high sensitivity and specificity. ECG may show non-specific changes but is
not diagnostic. Chest X-ray may show a widened mediastinum but is not definitive. Transthoracic
echocardiogram can visualize the aortic root but is operator-dependent and less reliable for the
entire thoracic aorta.
2. A 72-year-old female with a history of heart failure presents with acute shortness of
breath and orthopnea. Her oxygen saturation is 88% on room air. Which of the following
is the most appropriate initial intervention?
A. Administer furosemide 40 mg IV
B. Apply supplemental oxygen and position upright
C. Obtain a stat chest X-ray
D. Administer morphine sulfate
,ANS: B
Explanation: The immediate priority is to address hypoxemia with supplemental oxygen and
position the patient upright to improve respiratory mechanics. Furosemide (A) is an appropriate
treatment for fluid overload but follows initial stabilization. Chest X-ray (C) is diagnostic but does
not address the immediate oxygenation deficit. Morphine (D) is used selectively and is not first-
line.
3. A 58-year-old male with a history of cirrhosis presents with hematemesis. Vital signs are
BP 88/50 mmHg, HR 118 bpm. After stabilizing the airway and initiating fluid
resuscitation, what is the priority pharmacological intervention?
A. Administer vitamin K intravenously to correct coagulopathy
B. Initiate an octreotide infusion to decrease splanchnic blood flow
C. Administer lactulose to prevent hepatic encephalopathy
D. Start empiric broad-spectrum antibiotics
ANS: B
Explanation: In patients with suspected variceal hemorrhage, octreotide is the standard of care
to reduce portal venous pressure by constricting splanchnic vessels. Vitamin K (A) is slow-acting
and does not stop acute bleeding, lactulose (C) is for ammonia management, and while
antibiotics (D) are indicated later, octreotide is the priority for controlling the active hemorrhage.
4. A 55-year-old patient with cirrhosis presents with ascites. Which of the following is the
first-line pharmacological treatment for ascites management?
A. Furosemide
B. Spironolactone
C. Hydrochlorothiazide
D. Mannitol
ANS: B
Explanation: Spironolactone is first-line for ascites in cirrhosis due to hyperaldosteronism.
Furosemide may be added but is not first-line. Hydrochlorothiazide and mannitol are not used.
5. A patient with cirrhosis has hepatic encephalopathy. Which medication is first-line?
,A. Lactulose
B. Rifaximin
C. Metronidazole
D. Neomycin
ANS: A
Explanation: Lactulose is first-line for hepatic encephalopathy, reducing ammonia absorption by
acidifying the colon. Rifaximin is often added. Metronidazole and neomycin are alternatives.
6. A 58-year-old female presents with a 3-month history of progressive shortness of breath
and a dry cough. On examination, she has clubbing and fine basal crackles. Which of the
following is the most likely diagnosis?
A. Idiopathic pulmonary fibrosis (IPF)
B. COPD
C. Bronchiectasis
D. Pulmonary oedema
ANS: A
Explanation: The combination of progressive dyspnoea, dry cough, clubbing, and fine basal
crackles is classic for IPF.
7. A 68-year-old male presents with a 2-week history of progressive shortness of breath
and orthopnoea. On examination, he has elevated JVP, bilateral basal crackles, and
pitting oedema. Which of the following is the most likely diagnosis?
A. Heart failure
B. COPD exacerbation
C. Pulmonary embolism
D. Pneumonia
ANS: A
Explanation: The combination of dyspnoea, orthopnoea, elevated JVP, crackles, and oedema is
classic for heart failure.
, 8. A 45-year-old male presents with a 1-week history of severe, colicky abdominal pain and
vomiting. He has a history of previous abdominal surgery. On examination, there are
high-pitched bowel sounds. Which of the following is the most likely diagnosis?
A. Small bowel obstruction
B. Large bowel obstruction
C. Acute pancreatitis
D. Gastroenteritis
ANS: A
Explanation: The combination of colicky abdominal pain, vomiting, and high-pitched bowel
sounds in a patient with a history of abdominal surgery is classic for small bowel obstruction due
to adhesions.
9. A 55-year-old male presents with acute-onset, severe epigastric pain radiating to the
back. He has a history of alcohol use. Which of the following is the most likely diagnosis?
A. Acute pancreatitis
B. Perforated peptic ulcer
C. Myocardial infarction
D. Biliary colic
ANS: A
Explanation: The acute onset of severe epigastric pain radiating to the back in a patient with a
history of alcohol use is classic for acute pancreatitis.
10. A 70-year-old female presents with a 6-month history of progressive difficulty with
balance and coordination. On examination, she has an ataxic gait and intention tremor.
Which of the following is the most likely diagnosis?
A. Cerebellar degeneration
B. Parkinson's disease
C. Peripheral neuropathy
D. Vestibular dysfunction
ANS: A
Explanation: The combination of an ataxic gait and intention tremor is characteristic of
cerebellar dysfunction.
